Cancer mortality by urbanization and altitude in a limited area in Northeastern Italy

The geographical patterns of cancer mortality have been studied in Friuli-Venezia Giulia Region (1.2 million inhabitants), the North-eastern part of Italy, with respect to certain characteristics (i.e., rural, mixed, urban) and the altitude of the commune where the deceased subjects lived permanently at the time of death. In males, significantly increased mortality rates in rural versus urban communes (after allowance for altitude) were found for cancer of the oral cavity and pharynx, oesophagus and stomach. Conversely, significantly decreased mortality rates emerged for cancer of the colo-rectum, liver, lung, bladder, kidney and Hodgkin's disease. In females, significantly increased mortality rates in rural as compared to urban communes were observed for stomach cancer while significantly decreased mortality rates emerged for cancer of the colo-rectum, gallbladder, lung, breast, ovary, bladder and brain. With respect to altitude, residence above 200 meters retained a significant association in males, after allowance for the degree of urbanization of the commune of residence, for cancer of the oral cavity and pharynx, stomach and larynx (positive) and cancer of the colorectum and brain (negative). Women in locations above 200 meters seemed significantly at risk for stomach cancer, but protected from cancer of the colo-rectum and kidney. These results may provide a useful summary guide for further aetiological investigations into the risk factors associated with the diseases and give practical indications for local strategies of cancer control.